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Brief Interventions for Anxiety Disorders with Children and Adults
Anxiety Disorders continuing education counselor CEUs

Section 16
Risk Perception and Danger
Tug-of-War, Walking the Tightrope, & the 'Function of Dysfunction'

CEU Question 16 | CE Test | Table of Contents | Anxiety
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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Interference with Effective Performance
We now have to examine how the perception or the misperception of inadequate coping resources leads to anxieties. The key factor in maintaining stability in a presumably risky activity seems to be whether one has confidence that one can proceed without incurring an unacceptable risk. A person who seriously questions his or her ability to perform adequately or safely begins to experience inhibitions and anxiety.

The danger signals are triggered, and inhibitory pressures build up to discourage further movement into what one client termed the "danger zone." Anxiety, in this instance, is an unpleasant signal to stop forward progress. If your client stops or retreats, as you know, his or her anxiety decreases. If he advances, it increases. If he makes a conscious decision to proceed, he may be able to override the inhibiting anxiety.

The role of an inhibiting system may be viewed as a safety or precautionary mechanism, which is brought into play when there is a clear and present physical or interpersonal danger. The role of the inhibition is to curb or slow down action that can jeopardize safety. As long as your client is confident of being able to negotiate the task, the mechanism remains inoperative. As soon as his or her confidence wanes, the inhibiting mechanism is activated.

♦ Tug-of-War
Thus, there is a tug-of-war between advance... stop... go slow... and pull back. If your client proceeds skillfully and maintains his or her balance, he or she may remain cool. However, as soon as your client sees an unexpected trouble spot and is not certain whether or how he or she can handle it, they are likely to experience physical as well as psychological restraint. Which brings us to the function of dysfunctional behavior.

The "Function" of Dysfunctional Behaviors
The triggering of a self-protection mechanism is determined by your client's estimation of the amount of damage that will result if he or she performs inadequately. For example, the child, Bobby, tries to make good grades to prevent his parents pending separation. There is an interesting relationship between estimated magnitude of damage and the expectation of poor performance: that is, the more drastic the consequences of poor performance, the more poorly an individual expects to perform. Thus, the more the parents argue, the lower the child's school performance.

The child's reaction to a threat may be best understood in terms of a global perception of self-confidence. This construct refers to a constellation of attitudes involving Bobby's positive estimation of his instrumental capabilities and his belief in the ability to exercise them. Low self-confidence implies that the child has a low rating of his instrumental capacity and a negative expectation of success.

♦ 4 Questions Regarding Self-Confidence
The issue of self-confidence raises several questions:
1. What factors lower (or raise) self-confidence?
2. How does lowered self-confidence translate to impeded performance?
3. What psychological and physical mechanisms lead to poor performance?
4. What function is served by lowered self-confidence and the resulting deterioration of performance?

Of the factors affecting self-confidence in the presence of the degree of threat, I have already suggested that severity and probability of possible failure have a negative correlation with self-confidence. Thus, the prospect of a divorce will reduce confidence more than will the prospect of the parents staying together and still arguing.

On the other hand, the presence of a support system that the child can grasp as his anxiety increases may increase self-confidence. This safety feature provides a back-up system should the child go into freeze mode. But how does evaluation anxiety fit into this picture?
---The Evaluation Anxieties
---The Essence of Evaluation Anxieties
---Before the Fall

A client entering a socially-threatening situation is like someone walking a tightrope. He or she feels vulnerable to a serious mishap if his or her performance is not adequate. For safety's sake, the client must conform to a rigid set of rules regarding appropriate actions and movements -- in the case of our example, Bobby's grades.

The greater Bobby's confidence in his skill, the less likely he is to make a potentially fatal misstep, perform poorly on a test and receive a low grade. If his anxiety takes over, his performance may be sabotaged by freezing. Thus, this situation is a test of Bobby's ability and maturity. Smooth performance reaffirms his image of himself and maintains his favored status in his parents' eyes. Failure would shatter this image, and from his point of view, causes further arguments and ends in possible divorce.

♦ 3 Common Features of Evaluative Threats
There are certain commonalities among the various situations in which an individual may experience "evaluation anxiety." According to Greenberg, these evaluation threat situations can be grouped as follows:
1. Social situations:
initiating or maintaining a person-to-person relationship; participating in a social gathering (for example, a party);
2. A school or vocational situation: performance evaluated by a teacher (as in the case of Bobby), supervisor, or peer group, taking a test or examination, confrontation with a supervisor over a conflict of interest, athletic competition;
3. Transactions
in the "outside world" while shopping or traveling, with salespersons, waiters or waitresses, taxi drivers, or strangers.

♦ 7 Factors that May Aggravate
A complex web of factors in these situations may aggravate or create fears and anxiety. These factors involve the question of evaluation and vulnerability and include the following:
1. The relative status of the individual and the evaluator in the area of power and social desirability;
The individual's skill in presenting an attractive or effective "front";
His or her confidence in their ability to perform adequately in a given threat situation;
4. The client's
appraisal of the degree of threat, of the severity of potential damage and the probability of its occurring;
The threshold of certain automatic "defenses" (verbal inhibition, blockage of recall, suppression of spontaneity) that can undermine individual performance;
6. The rigidity and attainability of the "rules" relevant to acceptable performance, behavior, and appearance;
The anticipated punitiveness of the evaluator for nonadherence to rules or substandard performance, and so on.

6 Assessment Questions for Your Stress Reactions
The individual who is anxious on entering into an evaluative situation has a network of implicit questions. For example, let's look at your reaction or anxiety concerning this home study course. You may have had the following thoughts:
1. "To what degree is this a test of my competence or acceptability? How much do I have to prove to myself or others?"
2. "What is my status relative to that of my evaluators?" If the individual feels parity with or superior to the evaluator, then the rules are less narrow and more flexible and the prospective "punishment" for failure is less important.
3. "How important is it to establish a position of strength about relative power status (as in dealing with service personnel) or a position of acceptability in dealing with social evaluators (as in blind dates or speaking before an audience)?"
4. "What is the attitude of the evaluator? Is he or she accepting and empathetic or rejecting and aloof? Are his or her judgments likely to be objective or harsh and punitive?"
5. "To what degree can I count on my skills (such as verbal fluency) to carry me through?"
6. "What is the likelihood of my being undermined by distracting anxiety and inhibitions?"

Peer-Reviewed Journal Article References:
Dillard, A. J., Ferrer, R. A., Ubel, P. A., & Fagerlin, A. (2012). Risk perception measures' associations with behavior intentions, affect, and cognition following colon cancer screening messages. Health Psychology, 31(1), 106–113.

Hedman, E., Lekander, M., Karshikoff, B., Ljótsson, B., Axelsson, E., & Axelsson, J. (2016). Health anxiety in a disease-avoidance framework: Investigation of anxiety, disgust and disease perception in response to sickness cues. Journal of Abnormal Psychology, 125(7), 868–878.

Martin, K., Lang, F. R., Rupprecht, R., & Nömer, J. (2021). Dementia worry and the perception of personal risk: A longitudinal study. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 34(1), 23–30.

Mrkva, K., Cole, J. C., & Van Boven, L. (2021). Attention increases environmental risk perception. Journal of Experimental Psychology: General, 150(1), 83–102.

Notebaert, L., Masschelein, S., Wright, B., & MacLeod, C. (2016). To risk or not to risk: Anxiety and the calibration between risk perception and danger mitigation. Journal of Experimental Psychology: Learning, Memory, and Cognition, 42(6), 985–995.

Pabon, E., MacKillop, J., Palmer, A. A., & de Wit, H. (2020). Multidimensional latent structure of risk-related phenotypes in healthy young adults. Experimental and Clinical Psychopharmacology, 28(1), 55–64.

Online Continuing Education QUESTION 16: The question of self-confidence raises what question? To select and enter your answer go to CE Test.

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